Healthcare Provider Details

I. General information

NPI: 1588672497
Provider Name (Legal Business Name): JNJ PHARMA LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/04/2006
Last Update Date: 09/27/2025
Certification Date: 09/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

254 BELLEVUE AVE
HAMMONTON NJ
08037-1752
US

IV. Provider business mailing address

254 BELLEVUE AVE
HAMMONTON NJ
08037-1752
US

V. Phone/Fax

Practice location:
  • Phone: 609-561-0825
  • Fax: 609-561-9578
Mailing address:
  • Phone: 609-561-0825
  • Fax: 609-561-9578

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number28RS00071500
License Number StateNJ

VIII. Authorized Official

Name: SIDRA NAZ
Title or Position: PIC
Credential: RPH
Phone: 917-442-7100